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Heart & Cardiology/Septal Infarction on ECG


Hi Dr. Richardson,

I have read some of your posts on this topic and am hoping you would be willing to read my ECG.  I am 33 yr old male and in what I consider good health - 5'11'' 160lbs, exercise moderately 6 days a week, have a good diet, no cardiac symptoms (other than the fluttering).  I have an anxiety disorder (mainly panic attacks), and so my blood pressure is sometimes elevated, but averages about 128/80.  

I was in for a checkup yesterday with my PCP and mentioned to my Dr. that I had been experiencing some fluttering in my chest - what I thought were PACs or PVCs.  He agreed that it's probably what they were, but wanted to run an ECG just to be sure.  The ECG says possible septal infarction, which was very, very surprising to me - if not unbelievable.  

They ran the test twice, the first one says lead 3 was unsuitable, so they changed that lead and ran it again.  I asked the dr. for a copy and he gave me the first one and said that they looked the same and wasn't sure why the first one produced an error.

I last had an ECG at my former PCP at an annual checkup in 2010, just something he always did - and it was normal.    

My Dr. did not seem too concerned and but wanted to schedule me for an echo sometime in the next few weeks.  

My questions are:

- Is my ECG truly indicative of a septal infarction?
- Would you recommend that I go through with the echo?


Hello Chet,

Your EKG is normal.  The machine over-read it.  The sharp spikes called QRS have to be totally downward in V1 thru V3 to diagnose a septal infarct.  Yours is downward in V1 and V2 only, which is normal.

If your insurance covers an echo, then it might be worthwhile to be sure your heart's structure and function are normal as your exercise ability suggests.  You certainly don't have to have an echo.

Please write back if this note doesn’t answer all your questions.

David Richardson

Heart & Cardiology

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David Richardson


Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.


Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Circulation, American Heart Journal, Hypertension.

M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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